Sex Differences in Brain Metabolites after mild Traumatic Brain Injury: The Role of Hormonal Influences using 3T MRS

Motivation: Understanding sex and hormonal influences on brain metabolism following mild traumatic brain injury (mTBI) is crucial for personalized treatment. Goal(s): Comparing brain metabolites in men and women post-mTBI using 1H-MRS to healthy controls and high/low estradiol and progesterone levels. Approach: 3T MRS acquired in the posterior cingulate gyrus (PCG) and posterior white matter. Hormonal levels based on menstrual cycle phase or contraceptive intake. Results: Men showed significantly lower N-Acetyl-Aspartate (NAA) levels than women in the PCG post-mTBI. Regarding hormones, only women with high estradiol exhibited significantly increased NAA compared to men. In the control group, these differences could not be seen. Impact: Our results reveal hormone-dependent metabolic changes in the brain post-mTBI, emphasizing the role of estradiol in neuroprotection and the complexity of intake of oral contraceptives. This could inform future sex-specific therapeutic strategies for mTBI patients.